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Gold, incentives and meh


  • Fear of side effects the main driver behind patients not getting vaccinated

    Cobblers's comment 26 Jan 2019 1:09pm

    Society, via Government, should state that being vaccinated is a part of a citizen’s responsibility to each and all of us.

    There should be no compulsion as it does not take Einstein to see how that could be abused but freedom of choice, as a right, does come with the downside (responsibility) that choosing the antivaxers’s route does produce children that can cause harm to society. (I ignore in this discussion the damage caused to the child itself by having antivaxer parents, which is more a Child Protection Issue and, as such, an even bigger discussion)

    Should then society not try to mitigate that harm by ‘encouraging’ the genuinely worried to discuss their issues with professional health people and the refusers, the feckless, the can’t be arsed, the haven’t got the time, contingent be warned that society isn’t willing to embrace their children, either with money (Child benefit) or schooling?

    It sounds harsh but with herd immunity dropping and measles and polio rearing their heads again ready to cause death and long term disability (iron lung anyone?) isn’t it time to show a bit of backbone?

    /rant over

  • GP contract would include MMR vaccinations under PHE proposals

    Cobblers's comment 25 Jan 2019 12:15pm

    This is a PHE problem and it does nothing to foist it upon GPs who are already overworked.

    I agree with previous comments and would go further. Not only should PHE commence a public education campaign but also there should be a requirement to have a fully vaccinated child presented to school for enrollment. No vaccs no school. The further bit is that I would make child benefits paid on recognition of an up to date vaccination status.

    With rights come responsibilities.

    COI. Am currently walking the walk with my grandchild as she goes through her primary vaccs. Not fun for either of us. But being of an age to recall children dying of SSPE, Wakefield can caminar con satanás.

  • Seven in 10 medical students cannot afford basic necessities, finds survey

    Cobblers's comment 23 Jan 2019 11:46am

    Old news.

    Back in the day (late 70s) I worked every holiday and sometimes weekends to get me through med school. As the time commitment to medicine ramped up so did my overdraft, so much so that my bank manager 'requested' to see me and said that the business model was for them to make a living from my money not the other way round. As it was I pointed out that I was less than a year to qualifying and paying them back. He smiled.

    But, of course, at that time I believed medicine was a career worth continuing. Not so sure now.

  • GPs should consider childbirth as a risk factor for breast cancer

    Cobblers's comment 18 Jan 2019 12:14pm

    Scene Hospice bed circa 2060.

    Q So Mrs X I see you are lying here on your own?

    A Yes my husband died 2 years ago and we decided in 2019 not to have children based on a breast cancer study that showed that childbirth increased the risk of breast cancer.

    Q If I may ask why are you here?

    A I am dying of breast cancer.

    Carpe Diem is not a bad philosophy.

    Children do give more to your life than they take, usually.

  • Matt Hancock’s vision for IT is the worst idea I’ve heard in a long time

    Cobblers's comment 18 Jan 2019 12:06pm

    It was seem that Matt Handcock either doesn’t know or prefers not to know that the Government and IT ventures have a very very poor record.

    Defence Information Infrastructure cost 4.8 BILLION.
    NHS National Programme for IT cost 10 BILLION
    Universal Credit shambles cost 15.8 BILLION (admittedly not all on IT)

    I also noted a comment on researching this that those projects delivered with a fanfare are the most likely to blow up. “Ta Ra” anyone?

    So another vote here for Evolution not Revolution in IT for the NHS.

    Matt Hankook are you listening?

  • Staff shortages could stop NHS funding boost being used effectively, says NAO

    Cobblers's comment 18 Jan 2019 11:42am

    STOP PRESS - NHS has problems with recruitment and retention!

    STOP THE STOP PRESS - BMA surprised. (That powder must be tinder dry by now)

  • Stop supplying hypertension drug potentially containing carcinogen, GPs told

    Cobblers's comment 16 Jan 2019 5:53pm

    Pulse that is wrong. It is the combination drug Irbesartan-Hydrochlothiazide and NOT Irbesartan on its own.

    Please amend.

  • I’m sick of being the fall guy

    Cobblers's comment 14 Jan 2019 5:54pm

    Shaba: "I have already received a written warning from my Responsible Officer about a previous offering."

    Care to share?

    My personal experience of these people is that they may have a Dr in front of their name but the rest that follows is pure unadulterated gong chasing admindroid.

  • No target date for recruiting 5,000 extra GPs, says health secretary

    Cobblers's comment 11 Jan 2019 12:24pm

    "Don't you dare constrain me by the previous SoS's utterances"

    I have enough my own inanities to be going on with.

  • GPs should routinely test COPD patients for vitamin D status, says study

    Cobblers's comment 11 Jan 2019 12:21pm

    Google tells me that a Vitamin D test is about £20 each. Strangely the cost for a year's supply of Vitamin D is £20.

    I agree with Shaba, suggest to all your COPD patients to take supplemets OTC. Hell it's the cost of 2 x 20 packs of cigarettes! (Says Google)

    *At the risk of being contentious add in DHA/EPA oil and make it Cod Liver supplements.

  • ‘Person-focused’ GP consultations may reduce frequent attendance

    Cobblers's comment 09 Jan 2019 3:12pm

    You spend money, time and attention on Frequent Flyers and you may get a diminution in demand, short term. They are soon back with new stories, or the same old story, or just for a natter.

    And, guess what, time money and attention are in short supply in today's NHS.

  • Five-year GP-based training could start in 2021, says NHS England adviser

    Cobblers's comment 06 Jan 2019 9:33pm

    80 years ! Not that far back 'Took Early Retirement'. I qualified in 1979 and I could have gone straight into GP in 1980.

    However my path through the secondary care system of 3.5 years made me a much better and safer doctor.

    But this 5 year extended GP training fills me with extreme doubt. I chafed at 1 year GP trainee and was ready to go out into the wild world from month 9-12.

    I think, like a lot of these bright ideas, this 5 year course is going to have the opposite effect intended. Hopefully this pilot should show if they are right.

  • What can we expect for general practice in 2019?

    Cobblers's comment 04 Jan 2019 12:00pm

    "And I fear I will be writing this same blog next year." Indeed you might and to an even smaller audience of NHS GPs.

    And 2019 might also provide a tipping point where in some areas GP provision collapses and politicians and the Daily Mail wake up to the surprising (to them anyway) fact that if you sh!t on people they are inclined to move.


  • The NHS is the little old lady waiting for an ambulance

    Cobblers's comment 04 Jan 2019 11:53am

    Or, as a basic minimum, charge for the ambulance service. It is, after all, a glorified taxi.

    In Australia my relatives showed me their ambo insurance card which (at the time) was 50 cents a day. Non presentation of said card resulted in a quite a large charge for the use of the ambulance.

    Might concentrate minds in the UK in terms of usage?

  • GPs need better training in conflict resolution

    Cobblers's comment 18 Dec 2018 11:58am

    And as for the van incident I think you were lucky or you are built like a brick sh!thouse.

    Could have rapidly escalated to fisticuffs and damage to self or car. Or you could have dropped him and found yourself in the nick for GBH with loss of GMC rego and loss of job.

    Cheerful moi? Bah humbug. :-)

  • GPs need better training in conflict resolution

    Cobblers's comment 18 Dec 2018 11:53am

    Under GP Guidance-Fit Note pdf Page 14

    "If their employer cannot make any changes to
    accommodate your advice, the fit note is treated as if it stated that your patient was not fit for work. Your patient should not return to you for a new fit note stating this because they do not need one."

    Point that out to the patient and the employer. Wasted appointment.

  • An ode to St Matt and his ’appy new year

    Cobblers's comment 17 Dec 2018 7:48pm

    “The 3 stages of man: He believes in Santa Claus. He doesn’t believe in Santa Claus. He is Santa Claus.”

    I have finally made it to stage 3! Merry Christmas to all. (Let's hope Grandma is caught kissing Santa!)

  • An ode to St Matt and his ’appy new year

    Cobblers's comment 17 Dec 2018 7:45pm

    GP: “I want a magical Unicorn for Christmas”

    Santa: “Be realistic”

    GP: “Okay. I want 5 minutes to myself each day at work to drink my coffee hot and pee in peace.”

    Santa: “What colour Unicorn would you like?”

  • GPs asked to discuss faith with patients signing up to the organ donor register

    Cobblers's comment 17 Dec 2018 2:48pm

    Feck me if it's another job that people want to give GPs!!

    Correct me if Dr Richard Scott wasn't issued a "Warning" 6 years ago by the GMC for raising matters of faith in the surgery?

    Employ a 30 foot barge pole.

  • Health secretary bans GP practices from using fax machines

    Cobblers's comment 12 Dec 2018 2:38pm

    Mr Hancock you can ban the NHS from buying fax machines but anyone tell you that GPs are not part of the NHS? You can't ban them from buying faxes if it makes business sense to do so.

    In fact consider the fax machine as Plan B, a "Backstop" arrangement in case of IT failure (virus, hacking, DDOS attack). Or maybe letters via the post aka Plan C?